ULTRASOUND APPLICATORS FOR THERMOBRACHYTHERAPY

热疗已被证明可以大大提高 放射和药物在癌症的临床管理，但反应 肿瘤的联合治疗是高度依赖于均匀性， 目标体积内的加热的局部化。最近的研究 表明同时施加热量和辐射将 显著改善肿瘤控制，且长期最显著 持续间质加热与并行近距离放射治疗。为数不多 间隙加热技术， 治疗不能有效地控制温度 沿着植入物的长度分布，这通常转化为 加热均匀性差和最小热剂量低。 该建议描述了一项研究计划，以开发一种间隙加热 系统将比以前的技术更有效地提供 同时间质热放疗，以前难以 治疗大脑等部位。这包括：（1）直接开发 具有动态特性可植入多元件超声施加器 纵向功率沉积的控制，并允许 同时插入辐射源; 2）开发 治疗优化和控制软件，用于预先计划立体定向 根据热剂量和辐射剂量测定放置施源器 考虑因素，并调节功率水平，以达到均匀的温度 最大热剂量分布。 这种方法的影响将是最显着的目标在大脑中 其中稀疏注入和源的非平行对准通常 必要在未来，该系统可以很容易地适用于 其他部位，如前列腺，其中的优势，如能力， 沿着每个施加器的长度调节功率沉积， 精确控制加热的位置是至关重要的。主 目标是生产间质施用器和相关的规划 和控制程序，这将提供更统一和更大的整体 热剂量分布比目前可用的间隙加热 技术，并促进同时提供 热辐射疗法这种加热技术的发展将提供 一种改进的加热模式，可用于长期I/II期试验 同步热放疗

Hyperthermia has been shown to substantially increase the effectiveness of radiation and drugs in the clinical management of cancer, but the response of tumors to combined therapy is highly dependent upon the uniformity and localization of heating within the target volume. Recent studies have shown that applying the heat, and radiation concurrently will significantly improve tumor control, and is most dramatic for long duration interstitial heating with concurrent brachytherapy. The few interstitial heating technologies which are compatible for combined therapy exhibit an inability to effectively control the temperature distribution along the length of the implant, which often translates into poor heating uniformity and a low minimum thermal dose. This proposal describes a research plan to develop an interstitial heating system which will be more effective than former technologies in delivering simultaneous interstitial thermoradiotherapy to previously difficult to treat sites such as brain. This includes: l) the development of directly implantable multielement ultrasound applicators that feature dynamic control of the longitudinal power deposition and allow for the simultaneous insertion of radiation sources; 2) the development of treatment optimization and control software to preplan the stereotactic placement of applicators with respect to thermal and radiation dosimetry considerations, and regulate power levels to attain uniform temperature distributions of maximum thermal dose. The impact of this approach will be most significant for targets in brain where sparse implants and non-parallel alignment of sources are often necessary. In the future, this system may be readily adapted for use in other sites such as prostate, where advantages such as the ability to adjust the power deposition along the length of each applicator and precisely control the localization of heating are essential. The primary objectives are to produce interstitial applicators and associated planning & control programs which will provide more uniform and bigger overall thermal dose distributions than currently available interstitial heating technologies, and to facilitate the delivery of simultaneous thermoradiotherapy. The development of this heating technique will provide an improved heating modality ready for Phase I/II trials of long duration simultaneous thermoradiotherapy.